Current opinion in pediatrics · 2007
Steroid therapy for asthma in children.
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Spahn Joseph D, Szefler Stanley J
Аннотация
PURPOSE OF REVIEW: To highlight studies that have contributed significantly to our current knowledge of inhaled glucocorticoids in childhood asthma.
RECENT FINDINGS: In 2006, three important studies were published that investigated whether inhaled glucocorticoid therapy, if started soon after the onset of asthma symptoms, could alter the subsequent course of the disease. Several studies focused on the comparative clinical efficacy of inhaled glucocorticoids to leukotriene receptor antagonists in children with mild to moderate asthma. Although the Expert Panel had recommended inhaled glucocorticoid therapy as the preferred long-term controller with persistent asthma, there were no specific studies comparing these two classes of long-term controller medications in children. Another topic of significant clinical interest was the comparative efficacy of inhaled glucocorticoid to systemic glucocorticoids in the treatment of acute asthma. The question was answered in a study published in children with mild to moderate acute asthma. Lastly, the safety of inhaled glucocorticoid therapy was also evaluated in preschool children.
SUMMARY: Inhaled glucocorticoids are the preferred long-term controller for initiating treatment of persistent asthma. Early intervention with inhaled glucocorticoids achieves symptom control but does not alter the natural history of asthma. Inhaled glucocorticoids are not as effective as systemic glucocorticoids for managing acute asthma exacerbations.
RECENT FINDINGS: In 2006, three important studies were published that investigated whether inhaled glucocorticoid therapy, if started soon after the onset of asthma symptoms, could alter the subsequent course of the disease. Several studies focused on the comparative clinical efficacy of inhaled glucocorticoids to leukotriene receptor antagonists in children with mild to moderate asthma. Although the Expert Panel had recommended inhaled glucocorticoid therapy as the preferred long-term controller with persistent asthma, there were no specific studies comparing these two classes of long-term controller medications in children. Another topic of significant clinical interest was the comparative efficacy of inhaled glucocorticoid to systemic glucocorticoids in the treatment of acute asthma. The question was answered in a study published in children with mild to moderate acute asthma. Lastly, the safety of inhaled glucocorticoid therapy was also evaluated in preschool children.
SUMMARY: Inhaled glucocorticoids are the preferred long-term controller for initiating treatment of persistent asthma. Early intervention with inhaled glucocorticoids achieves symptom control but does not alter the natural history of asthma. Inhaled glucocorticoids are not as effective as systemic glucocorticoids for managing acute asthma exacerbations.